I sometimes cannot get my desk top icons to work. What do I do to fix it. Refresh does not do it.

Please provide more information.
What happens when they are "not working"

I am going to assume that you're saying they sometimes do not show up. This can be caused by a number of reasons. Usually ending the explorer.exe process and then going to "New Task" and typing in "explorer.exe" (Without Quotes), then clicking OK, will usually solve the problem.

If you can see them, and they just "don't work" your computer may be freezing up, and that has another whole slew of problems associated with it.

In any case, either can actually be attributed to too many processes running. I would suggest you clean up your startup services and programs.